Provider Demographics
NPI:1427093376
Name:MCCABE, SANDRA A (MD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:A
Last Name:MCCABE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:A
Other - Last Name:ARMATYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1801 N SENATE BLVD
Practice Address - Street 2:STE 220
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-962-3700
Practice Address - Fax:317-962-8800
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI49159208800000X
IN01070526A208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000749529OtherANTHEM PIN
IN264430469OtherMEDICARE PTAN
INP01941209OtherRAILROAD PTAN
IN201047370Medicaid
I55528Medicare UPIN